A Shropshire schoolgirl who died after being misdiagnosed with swine flu might have been saved if doctors had recognised her tonsillitis in time, an inquest has been told.
Charlotte Hartey, 16, died in July last year from complications arising from tonsillitis after being diagnosed with swine flu over the phone by a GP and prescribed the anti-viral drug Tamiflu.
The teenager, from Bronygarth near Oswestry, died in hospital on July 31 after the rare bacteria which caused her tonsil infection travelled through her body, leading to her developing bronchial pneumonia.
An inquest into her death at Shrewsbury Magistrates' Court heard that she was admitted to hospital on July 29 - seven days after being prescribed Tamiflu - when blood tests showed an alarmingly high white blood cell count, indicating a serious infection.
Dr Kenneth Scott, who conducted a post-mortem examination on Charlotte's body, told the inquest he believed it was unlikely she could have been saved after her admission to hospital but said she may have lived if tonsillitis had been diagnosed initially instead of swine flu.
He said: "She died from her lung condition because she couldn't breathe anymore. She had not enough lung function left to survive.
He added: "I think the chain started when she got tonsillitis... that is when it all began."
The pathologist said it was his opinion that "the outcome could have been different" if the teenager had been prescribed the correct antibiotic medication at the outset, rather than Tamiflu, which does not fight infections.
He said: "I would concur with Mr Hartey's (Charlotte's father) view that if the tonsillitis had been diagnosed on July 22 and the appropriate antibiotics given and taken in the correct dosage, there could have been a possibility that the outcome could have been different.
"With a correct diagnosis, the correct antibiotics and the correct dosage, given early enough, the outcome could have been different.
"The sooner an individual, a patient, gets the correct treatment, the better."
Dr Scott added: "By the time she reached hospital she was extremely ill. I think it is probably unlikely that she would have survived at that point, it is possible, but she really was very ill.
"The chances of survival at that point were really quite small because she had got a systemic infection which just got progressively worse.
"I can't think of any other treatment that could have been given that wasn't given. I think the balance of probabilities was that she wouldn't live."
Dr Michael Arthur, the GP who prescribed Tamiflu, told the inquest he conducted a consultation by phone in accordance with NHS guidelines at the time, when the swine flu virus was sweeping the UK.
The doctor said Charlotte's symptoms, which included a sore throat, runny nose and persistent cough, were "strongly suggestive" of a virus, rather than an infection.
He said: "At that time swine flu was the most serious and most likely cause of flu-like symptoms and it was for this reason I suspected Charlotte had swine flu.
"If there was anything to suggest that this was not a viral illness I would have asked the patient to come into the surgery.
"She didn't have any symptoms which made me think it wasn't a viral illness."
Dr Arthur said in particular the presence of a cough and a runny nose would not be associated with a tonsillitis diagnosis and led him to believe Charlotte had a virus rather than an infection.
The inquest heard that two days after Tamiflu had been prescribed, Charlotte's mother Helen Hartey called doctors requesting a home visit for her daughter.
GP Dr David Campbell visited that day and told the court he agreed with the swine flu diagnosis but also noticed that Charlotte's throat was inflamed and prescribed a course of antibiotics.
The doctor visited Charlotte's home again on July 28, when he decided it would be "prudent" to take swabs and a blood sample for a full blood count analysis, which subsequently revealed the extent of Charlotte's illness.
Dr Campbell said: "Charlotte's death was a tragedy...her death was a considerable shock to me, it was so unexpected."
Dr Scott told the inquest that in the days leading up to her death Charlotte was probably "more ill than she looked".
He said: "She was an extremely sick girl when she was admitted (to hospital). She was much sicker than she appeared.
"Young people can look less ill than they are and I think that's what happened here. She didn't look moribund or as though she was dying, but in fact she was."
The pathologist said the bacterial infection which led to Charlotte's death was "highly highly highly unusual" and one he had never come across before.
He said: "We are talking about something which is highly unusual. I don't know whether that helps the family at all but it is very rare."
Dr Campbell, who has 31 years experience as a GP in Oswestry, and John Farrow, an ear nose and throat specialist at Shrewsbury and Telford NHS Trust, both also said they had no experience of the specific bacteria - arcanobacterium haemolyticum - which had infected Charlotte's body.
The inquest was adjourned to Thursday.